Individual provider Active NPI

Charishma Sudhan, PA

  • Physician Assistant
  • Jamaica, NY
National Provider Identifier
1598217796
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8268 164TH St
Suite 1B-02
Jamaica, NY 11432-1121
Phone
(718) 883-3070
Fax
(718) 883-6115
NPI assigned
Nov 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

8268 164TH St
Suite 1B-02
Jamaica, NY 11432-1121

Mailing address

8268 164TH St
Suite 1B-02
Jamaica, NY 11432-1121
Phone (718) 883-3070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180430001284 NY Practitioner - Physician Assistant 0244514693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Samaritan Medical Services PCGroup PAC ID 7012016009, 341 clinicians

Practice addresses (Care Compare)

100 Port Washington Blvd
Roslyn, NY 11576-1347
Phone (516) 325-7520

1000 Montauk Hwy
West Islip, NY 11795-4927
Phone (516) 705-2689

Hospital & facility affiliations

  • St Francis Hospital - the Heart Center Hospital, Roslyn, NY, CCN 330182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1598217796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "address_2": "SUITE 1B-02",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321121",
            "telephone_number": "718-883-3070",
            "fax_number": "718-883-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8268 164TH ST",
            "address_2": "SUITE 1B-02",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114321121",
            "telephone_number": "718-883-3070",
            "fax_number": "718-883-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDHAN",
        "first_name": "CHARISHMA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

Verify at the official NPI Registry.